Provider Demographics
NPI:1275121204
Name:DAVIS, ARTHUR JR
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:
Last Name:DAVIS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2379 CASSELMAN RD
Mailing Address - Street 2:
Mailing Address - City:ROCKWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:15557-6724
Mailing Address - Country:US
Mailing Address - Phone:814-926-2167
Mailing Address - Fax:
Practice Address - Street 1:2379 CASSELMAN RD
Practice Address - Street 2:
Practice Address - City:ROCKWOOD
Practice Address - State:PA
Practice Address - Zip Code:15557-6724
Practice Address - Country:US
Practice Address - Phone:814-926-2167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant